Drug interactions
Hydrochlorothiazide-valsartan + Ketorolac
Severity: Major
Hydrochlorothiazide-valsartan and Ketorolac: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ketorolac can lessen the blood pressure control from valsartan and hydrochlorothiazide, and the three drugs together carry a notable risk of acute kidney injury and hyperkalemia. Risk is higher in older, dehydrated or renally impaired patients.
What this interaction means in plain words
Hydrochlorothiazide-valsartan and Ketorolac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Hydrochlorothiazide-valsartan belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, compounding angiotensin receptor blockade and diuretic-induced volume loss.
What to do
Avoid combination where possible and limit ketorolac to the shortest course, ensuring adequate hydration. Monitor creatinine, potassium and blood pressure during use.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Hydrochlorothiazide-valsartan
- Aliskiren + Hydrochlorothiazide-valsartan Contraindicated
- Dofetilide + Hydrochlorothiazide-valsartan Contraindicated
- Hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-valsartan Major
- Amifostine + Hydrochlorothiazide-valsartan Major
- Amiloride + Hydrochlorothiazide-valsartan Major
Other interactions of Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Apixaban + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Ketorolac?
MediHelp rates the interaction as major. Hydrochlorothiazide-valsartan and Ketorolac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketorolac can lessen the blood pressure control from valsartan and hydrochlorothiazide, and the three drugs together carry a notable risk of acute kidney injury and hyperkalemia. Risk is higher in older, dehydrated or renally impaired patients.
How serious is the interaction between Hydrochlorothiazide-valsartan and Ketorolac?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combination where possible and limit ketorolac to the shortest course, ensuring adequate hydration. Monitor creatinine, potassium and blood pressure during use.
What other medicines interact with Hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-valsartan page.
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